![]() ![]() This policy will not amend the school law Section 41-23-37, Mississippi Code of 1972. Download Exemption Request (Form 139-M).The exemption expiration date will be based on the circumstances for the exemption, and will be no less than one school year unless otherwise indicated on the request. The original Certificate of Medical Exemption (Form 122) will be housed at MSDH.ĭata regarding medical exemptions will be maintained in the Immunization area of the MSDH website. The State Epidemiologist or Deputy State Epidemiologist will mail a copy of the Certificate of Medical/Religious Exemption (Form 122) to the parent and the pediatrician, family practitioner, internist, or tertiary care physician who submitted the Medical Exemption Request.Form 139-M must be submitted to the Mississippi State Department of Health Epidemiologist or Deputy State Epidemiologist.The same pediatrician, family physician, internist, or tertiary care physician must indicate on Form 139-M the medical condition of the child seeking exemption and indicate the exemption status for each of the listed vaccines.Medical exemption requests completed and signed by a tertiary care physician outside of the state will be reviewed on a case by case basis. ![]()
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